Bus Stop Safety Checklist Form
Complete this checklist to assess and report the current safety condition of the bus stop.
Inspection Date and Time
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Bus Stop Location or Identifier
*
Inspector Full Name
*
First Name
Last Name
Inspection Method
*
On-site
Remote (visual/virtual)
Other
Is the bus stop accessible for all users (including those with disabilities)?
*
Yes
No
Partially
Lighting Condition
*
Adequate
Poor
None
Shelter Condition
*
Good
Damaged
Missing
Signage Visibility
*
Clear
Obstructed
Missing
Sidewalk/Pavement Condition
*
Good
Uneven/Damaged
No Sidewalk
Curb/Ramp Condition
*
Good
Damaged
No Ramp
Cleanliness of the Bus Stop
*
Clean
Moderate Litter
Heavily Littered
Are there any surrounding hazards (e.g., traffic, construction, poor visibility)?
*
Traffic hazards
Construction nearby
Poor visibility
None
Other
Overall Safety Rating
*
1
2
3
4
5
Notes / Issues Found
Recommended Corrective Actions
Is urgent maintenance required?
*
Yes
No
Follow-up Date (if applicable)
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Submit Checklist
Should be Empty: